Kevin Durant injured the Knee: What is Bone Bruise?

Kevin Durant from NBA Golden State Worriers suffers from knee injury. It happened last night (2017.02.28) vs. Washington. MRI showed that Grade 2 Medial Collateral Ligament (MCL) sprain and a tibial bone bruise. He will be out indefinitely and will be evaluated in 4 weeks according to the team. 

Bone bruise? It is just a bruise. The bone just got a hit so it is not a big deal, right? You may think that way. Bruise sounds not as serious as broken, tear or rupture. However, it is actually more than just a bruise. It is more painful than bruise on skin.

Example of bone bruise image. Not his.

What is Bone Bruise?
Bone bruise can be defined as a step before the fracture. Bone bruise is a fracture of inner layer of the bone and accumulation of blood and fluid due to the fracture; however, outer layer of the bone is intact. 

Fracture vs Bone Bruise
Fracture is that both the outer layer and inner layer of the bone are completely broken. On the other hand, bone bruise is that only the inner layer of the bone was broken, but the outer layer of the bone is intact. 

Bone bruise is usually occurred that compression force is applied to the bone. It may be 1. bone to bone impact in the joint or 2. direct force to the joint from outside. Bone bruise is seen in sports such as football, soccer and basketball. It happens with sudden stop, hard landing on the floor or sudden bending of the joint. Regarding bone bruise to the knee joint, it is associated with ligamentous tear such as ACL or MCL tear. It is found with 80 % of ACL rupture and is in femur condyles or in tibial plateau.

Sings and Symptoms 
Severe pain and joint swelling are commonly seen with this injury.

MRI detects bone bruise. Since damage is inside of the bone, X-rays do NOT show bone bruise. 

Rest. Non weight bearing to the joint with crutches. Splinting with brace. Since bone bruise is similar to fracture, it is treated pretty much same as fracture. 

Healing Time
It is commonly 6-8 weeks or more. 

DeAngelis, P. Joseph and Spindler, P. Kurt, Traumatic Bone Bruises in the Athlete’s Knee, Sports Health, 2010 Sep; 2(5): 398–402.

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